LAMC Screener Anita Vigil checks Geniece Courtright’s temperature as part of the screening process before entry into the hospital. LAMC Infection Preventionist Joyce Richins, RN, is in the background observing the process. Photo by John McHale/ladailypost.com

By CAROL A. CLARK
Los Alamos Daily Post
caclark@ladailypost.com

Los Alamos Medical Center (LAMC) began enacting strict measures in March in an effort to prevent the spread of the coronavirus pandemic.

While other communities have seen high numbers of COVID-19 cases in New Mexico and across the nation and world, Los Alamos has seen just six cases until Sunday when the number rose to seven.

Infection Preventionist Joyce Richins, RN, is leading the prevention effort at LAMC. She has worked at LAMC for 27 years.

“Joyce has been essential to helping track the ever changing COVID updates,” LAMC CEO John Whiteside said. “She has worked long tireless hours making sure our staff and patients are protected.”

Richins explained that all hospital staff are screened daily. If they answer yes to specific questions, they might be asked to avoid entering the hospital until their supervisor is notified, she said, adding that depending on the situation, they may not be able to work. 

“Strict guidelines are in place to help prevent the transmission of any possible infection and an employee may require a negative COVID-19 test prior to returning to work,” Richins said. “These precautions are in place to protect our staff and patients. We have increased our routine cleaning schedules and added staff as needed. Not only is our environmental service staff responsible for cleaning, but all staff are educated on appropriate cleaning of equipment and staff were reeducated on proper use of PPE and hand hygiene.”

All LAMC employees, patients, doctors’ office employees, delivery personnel and others are screened every time they enter the facility, Richins said. Also, everyone enters the hospital through the main entrance or the emergency entrance … the cafeteria entrance is closed … this helps control the flow of patients and puts personnel in one location where they can assist patients to their destination when necessary.

“To help ensure the safety of everyone, LAMC maintains a zero visitor policy at this time, with exceptions such as care givers,” Richins said. “For patients answering yes to screening questions we have a process in place to safely escort them to their destination, to help limit the possibility of spreading the virus. A separate room is set up for any suspected patient to separate them from others. These patients are escorted to their destination and also as they leave the medical center.”

Richins described the protocol now in place when entering the medical center.

A sign displayed at the entrance to the medical center states:

• All persons who enter LAMC will be screened at the main entrance;
• No visitors are allowed at this time;
• Please wear a mask at all times during your visit;
• Cover your mouth and nose when coughing/sneezing;
• Use and dispose of tissues;
• Perform hand hygiene after contact with respiratory secretions; and
• Restrict your visit to your designated location.

“As you enter the lobby, you are directed toward the right to where the screening table is located,” Richins said. “Green tape placed on the floor 6 feet apart indicates the appropriate social distancing for everyone to maintain. Screeners wearing masks and eye protection invite you to step up to the table and ask where you will be headed. They ask several questions related to travel, history of exposure and symptoms – which we update as new information comes from the CDC. Screeners also take temperatures with infrared, no touch forehead thermometers. If you are not wearing a mask, you will be given one to wear, typically a cloth mask donated by various volunteers, some local, some from out of state.”

Once this process is completed, those screened receive a dated green wristband, indicating they have been screened, she said, adding that for outpatient services such as lab and radiology, folks are directed to a registrar who enters them into the system, then asks them to sit in the lobby waiting area where chairs are separated for appropriate distance.

Next steps:

• An admitting clerk will ask similar questions and direct patients to their destination;
• Wearing a mask, patients head to the lab or radiology;
• All employees wear masks in public and patient care areas at all times;
• Plexiglas protects employees at the lab/radiology reception desks; and
• Procedure areas are cleaned after each patient.

For outpatient surgery, patients are directed to the third floor and shown to a pre op room, Richins said, and most outpatient surgery patients have a COVID-19 test prior to their procedure. Staff meet the patient several days before the scheduled surgery and perform the COVID-19 specimen collection from the patient while in their vehicle.

On the Med surg inpatient floor there is a separate COVID-19 section of the inpatient unit. A temporary plastic barrier encloses the area and negative pressure machines remove contaminated air from the space.

OB has a room for a COVID19 patient, similar to those on Med surge with a plastic containment area outside room. ED has a room with a plastic containment area as well.

Once patients conclude their visit to LAMC, a screener removes their green wristband as they exit the building.

Screener Mike Hoog checks Virginia Kachelmerier’s temperature Monday morning as part of the screening process at LAMC as Infection Preventionist Joyce Richins observes at left. Photo by John McHale/ladailypost.com

Screener Mike Hoog is asking Virginia Kachelmerier questions about her health Monday as part of the screening process at LAMC as Infection Preventionist Joyce Richins observes the process. Photo by John McHale/ladailypost.com

Screener Anita Vigil places a wrist band on Geniece Courtright’s arm to signify she has been screened. Photo by John McHale/ladailypost.com